M A Y 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 2 1
re-gown; re-towel the surgical wound; close the fascia; and close the skin.
3. After surgery
The precautions continue into recovery, where PACU nurses monitor
patients to make sure blood sugar levels never creep up past the 200
mg/dL mark. We also aim to maintain normothermia through regular
monitoring — PACU nurses record body temperature readings every 5
to 15 minutes when patients first come into recovery — and reapply
forced-air warming if necessary. Finally, our discharge instructions
remind patients to wash incision sites daily with CHG.
Worth the effort
If you really want to tackle SSI prevention from all angles, you need a mul-
tidisciplinary team. Ours consisted of surgeons, infection preventionists,
nursing leadership, clinical educators, pre-op and PACU coordinators and
educators, anesthesia providers and sterile processing representatives.
Why involve so many different staff members and departments? In
health care, we tend to silo ourselves off and don't always fully under-
stand exactly what those around us are doing. But when you tackle a
multifaceted problem like surgical infections as a team, you're almost
guaranteed to achieve better outcomes.
With our team in place, we started conducting back-to-basics audits
— sometimes 50 per month — of our SSI prevention protocols. These
audits include an observation of our scrubbing technique (see
"Breaking Bad Habits at the Scrub Sink") and our case preparation,
which involves making sure supplies and equipment are ready before
the case in order to reduce OR traffic.
Was our multilevel approach to reducing SSIs a lot of work? You
bet. Was it worth the effort? Without a doubt.
OSM
Ms. Lamoreux (mllamoreux@geisinger.edu) is a clinical nurse educator at
Geisinger Wyoming Valley and Geisinger South Wilkes-Barre in Wilkes-Barre, Pa.
